Approve coverage for my daughters cochlear implant
  • Petitioned Cigna

This petition was delivered to:

Cigna

Approve coverage for my daughters cochlear implant

    1. Petition by

      John Fitzmayer

      Loganville, GA

My daughter Nicole was born with several health issues. In her first four months of life she had three bowel surgeries, one heart surgery, bacterial meningitis, and we learned that she would need a liver transplant. We also learned that Nikki suffered from undetermined hearing loss, however during that time the doctors and her family was focused on life saving procedures. Nikki is now three years old (almost 4) and she has neuropathy in her left ear and has been pronounced profound deaf in her right ear.

We have been fortunate to be able to send Nikki to the Atlanta Speech School, which has worked wonders with her speech ability. However, her speech pathologist, therapist, teachers, and doctor have determined that Nikki has reached a plateau and will not likely improve in her speech or hearing abilities. Based on her doctor recommendation along with the advisors at the speech school, we requested Cigna (my employer provided insurance) to cover the cost of the cochlear implant. Cigna denied to cover the implant based on information provided and we appealed.

The initial reason Cigna denied coverage was stated that Nikki’s hearing loss was not significant enough and she had not utilized hearing aids for at least a three-month period. During the appeal Cigna was informed that Nikki had in fact utilized hearing aids in both ears for more than two years, and her deafness was far greater than what Cigna required. Cigna denied our appeal for coverage stating that they felt that Nikki was progressing or could progress with further use of hearing aids. Due to Nikki being immune suppressed it is difficult to keep her healthy long enough to have a surgery, (she has had at least 8 pneumonia infections in the last year and a half). We have her scheduled to receive the implant at the end of July, however without coverage Nikki will not be able to receive the implant. 

Nikki is now three years old and has overcome so much adversity in her young life. According to the rules she is “disabled”, but with the cochlear implants that would enable her to hear she would no longer be “disabled”. Change.org was able to assist another family in the same area that we live who were also undergoing the refusal of the insurance company. I work as a police officer and my wife is a lawyer who provides legal services to indigent clients as well as others.

In Georgia it seems that insurance companies do not cover any hearing loss coverage. Nikki’s hearing aids were provided for her when she was eligible for Medicaid under the Katie Beckett waiver, however due to the recent changes in the Medicaid coverage, Nikki is no longer eligible to receive the Katie Beckett waiver. Our family hopes that with the support of this petition Nikki will be able to receive her cochlear implants, and other children and their families will not have to endure the hardships of deafness when there is a potential remedy available.

My understanding of the cost of a cochlear implant is each ear cost about $125,000.00. Nikki, like other kids and adults who receive cochlear implants require intense therapy to “train” their brain to hear again. Based on information cochlear implants are performed on a regular basis with overwhelming success. We want our baby girl and others like her to be able to grow and enjoy life with every opportunity. I would be willing to pay even more than I do for the insurance premium, but how can anyone say that hearing is not medically necessary as was stated by Cigna?

Please sign this petition so that Nikki and others like her can receive this life altering procedure.

To:
Cigna
Approve coverage for my daughter's cochlear implant.

Sincerely,
[Your name]

Recent signatures

    News

    1. A pause in the battle

      John Fitzmayer
      Petition Organizer

      First, my family and I would like to thank all 172,000 plus people who have supported and aided us in our campaign. In speaking with the administrators of our health plan, I believe we were on the verge of victory, unfortunately, Nikki's cranial anatomy will not support a cochlear implant without risks to her health that we are not willing to take. I have spoken further with the health insurance company and they have agreed to accept a letter with research data to demonstrate why their policy is out of date and needs t one amended. (The plan does not include auditory neuropathy). With the press coverage generated in this I believe that some people in the legislature and in the high offices of the different insurance companies understand the power of everyday people to affect change. Our family will now regroup, re-think, and plan for our new future. Again we thank you all for your support.

    2. Another Setback

      John Fitzmayer
      Petition Organizer

      My amazingly strong wife wrote this update after todays heart breaking news.
      Nikki has run into yet another obstacle in her life. Not a life-threatening one as her others have been, but definitely a life-altering one. She did not get her implant today. I knew something was wrong when the surgeon came out too early (after only 2 hours) and wanted to meet with us in a private consult room. Nothing good has ever come out of those meetings for us. She has nerves in the wrong places, bones where bones should not be, and empty spaces where bones should be. There is physically no way to get to her cochlear without risking doing major damage somewhere else. One way and her face could be paralyzed, another way she could suffer permanent vertigo, another way she could suffer from seizures. Her CT scan had shown some contorted anatomy, but we never expected to hear this. I emotionally feel like I have been run over by a truck. Doing a cochlear on her other ear is not really an option right now because there is no guarantee it would work with her auditory neuropathy. If it didn't, then she would have no hearing left at all. So for now, we will leave her with the sound she does have. However, she will need to learn sign language in order to be able to effectively communicate. And so, our path of life has changed, again. It's not the end of the road, just a different one.

      As an amazing show of sisterly love, when we got home this evening and told Nikki's older sister (Sammie is 6), that Nikki would not be receiving her new hearing device, Sammie went to her room, found her book on beginning sign language, and proceeded to sit on the couch with Nikki and her youngest sister. The next twenty minutes were spent with the three of them on the couch practicing beginning sign language.

    3. Today's the day

      John Fitzmayer
      Petition Organizer

      This morning Nikki went into surgery for her Cochlear Implant; no the insurance is still not covering it, but the hospital has agreed to a payment plan after the procedure. As always, Nikki fought hard when they took her away, but after the surgery she will not remember anything. Please continue to spread this petition, we are still fighting the insurance company, we just could not wait any more to get this done. The Associated Press did a lengthy interview with our family on Thursday, we are looking forward to the story this weekend. In the meantime, please continue to spread this site and also
      https://www.indiegogo.com/projects/help-nikki-hear--3/x/8460809
      I will update this evening when Nikki gets out of surgery and home.

      HELP NIKKI HEAR

      Nikki Fitzmayer is losing her hearing and needs our help to get her a Cochlear Implant!

    4. A Convoluted Mess .

      John Fitzmayer
      Petition Organizer

      This morning Nikki happily performed in front of the camera following a Channel 2 News interview which can be viewed here http://www.wsbtv.com/news/news/local/family-seeks-help-covering-4-year-olds-250k-ear-im/nhJGK/

      This afternoon I spoke with the president of Covenant Administrators. It seems that last March when we first tried to get the Cochlear Implant approved, CIGNA mistakenly processed the application when they should not have. They continued to process it for the next five months, mistakenly. I was informed by the Covenant Administrators that due to the language in the plan, our request for coverage for Nikki's Cochlear Implant is still not medically necessary. We will be going forward with an external review, however, since the language of the plan states "bilateral hearing loss" and Nikki suffers from hearing loss in one ear, and Auditory Neuropathy in her other ear, (which is not covered in the plan), then it seems that our insurance will not be covering the implant. While we wait for the next review, we will be pushing forward with Nikki's surgery this Friday. Children's Hospital of Atlanta at Egleston has graciously agreed to go ahead with the procedure.
      Since the beginning of this petition, Christopher Harris and Cory Skyler Drouillard of Hollywood California have generously donated so much of their time and talent in putting together a video for Nikki that can be viewed at
      https://www.indiegogo.com/projects/help-nikki-hear--3/x/8460809
      Without these two individuals giving so much of themselves, and letting our family know how much Nikki's story means to them, we would not have this venue to spread the word about the insurance system, and how it affects families around the country and throughout the world. Chris and Cory, we thank you. We also would like to thank everyone who has provided us support and encouragement. Through this difficult journey, my wife and I have met so many families just like ours, and we hope to be able to bring about change to the health industry so that families just wanting whats best for their children can get it, based on advice from doctors that know their patients, not insurance industry personnel who have no vested interest.

      Family struggles to find $250K to fix daugher's hearing

      WALTON COUNTY, Ga. - A Loganville family says their 4-year-old desperately needs medical devices to help her hear and insurance won't cover it. The insurance company says it reviewed the case and decided it wasn't a medically necessary procedure. The Fitzmayer family says they are moving forward and have scheduled the child's cochlear implant surgery for Friday.

    5. Amazed

      John Fitzmayer
      Petition Organizer

      We are continuously amazed at the world-wide support we have received through this ordeal. Almost 200,000 signatures on this petition; thats a lot of people who have taken time from their day to show their support for us, and we truly appreciate it. I received a message on the https://www.indiegogo.com/projects/help-nikki-hear--3/x/8460809 and a company; Virtuous Prom, has offered to generously donate sales from one of their dresses. Here is the link to their website https://www.etsy.com/listing/200747603/custom-flower-girl-dress?
      Now none of my daughters are old enough to date, let alone marry, but when the time comes we know where we will get their dresses. We thank you for your continued support.

      Custom Flower Girl Dress

      Looking for a flower girl dress that perfectly matches your wedding dress or bridesmaid dresses? Looking for something unique, special and one of a kind for your flower girl? Look no further! Virtuous Prom is pleased to offer custom-made flower girl dresses starting at $80.

    6. The Full Scoop

      John Fitzmayer
      Petition Organizer

      So after a roller coaster of a day yesterday, hearing that CIGNA agreed to pay, then they didn't, then it was someone else. Here is the scoop as much as I can understand it (which is not much).The city I work for is self insured, but use a re-insurance?? for certain procedures (generally when the cost for a procedure is high, like a cochlear implant), then an insurance company (CIGNA) picks up the cost or provides access to the doctors and the hospitals. For all of Nikki's previous procedures that cost enough for the re-insurance to provide for, we had to request for coverage before the procedure. Prior to the cochlear implant we did not have any major issues. With the Cochlear Implant, CIGNA is saying that the request for services has to go through a company called Med Watch. Med Watch is a company used by CIGNA to determine medical necessity. (they previously denied the medical necessity for Nikki's Cochlear Implant when asked by CIGNA). So all of the information that had been sent to CIGNA has now been sent to Med Watch. (this of course all occurs without the knowledge of the patient or the family). CIGNA is saying that they mistakenly processed the original request for the Cochlear Implant in the wrong manner. (would have been nice t know this 5 months ago). This is the best information I have, and if anyone can make sense of it please let me know. Now we are just hoping that the request is sent to the right people, who knows. In the meantime, please continue to share this story with everyone. It is what thousands of families go through each year, for no reason. What a waste of time, resources, and money. Below are links so that this story can be shared with others.
      https://www.indiegogo.com/projects/help-nikki-hear--3/x/8460809

      Share the petition on your Facebook page: http://on.fb.me/1uCpXTS

      If you're a Twitter user, click this link to tweet your support: http://bit.ly/1wb4vGN

      One more thing, Nikki made the front page of the Walton Tribune!, She was very happy to see her picture on the front page.

    7. roller coaster

      John Fitzmayer
      Petition Organizer

      We received a telephone call today and were informed that CIGNA said they would cover the implant. We were of course ecstatic. Then the next call came, CIGNA actually said that they mistakenly processed the application for the implant procedure when they should not have. According to CIGNA, they should not be the ones making the decision. So we are now back to where we started. Nikki's information will be sent to another company so they can make a determination. I can now count at least three layers of bureaucracy between patient and doctor. Its a system designed to fail. Please continue to show your support by sharing this petition with your friends, family and anyone else. The below links will connect to Facebook, twitter, and indegogo.com

      https://www.indiegogo.com/projects/help-nikki-hear--3/x/8460809

      Share the petition on your Facebook page: http://on.fb.me/1uCpXTS

      If you're a Twitter user, click this link to tweet your support: http://bit.ly/1wb4vGN
      Amazing how CIGNA just happened to catch this now.

    8. easy links

      John Fitzmayer
      Petition Organizer

      I was contacted by Mr. Perri who is a manager at change.org. He graciously provided these quick links so that everyone can share this story and we can get the word out.
      Share the petition on your Facebook page: http://on.fb.me/1uCpXTS

      If you're a Twitter user, click this link to tweet your support: http://bit.ly/1wb4vGN

      We would like to thank everyone for their continued support and are looking forward to being able to affect some change so that other families do not have to endure the headaches of dealing with a bureaucracy while at the same time being worried about the health care of loved ones.

      Please also continue to spread these links for continued stories and updates.
      https://www.indiegogo.com/projects/help-nikki-hear--3/x/8460809

      http://monroelocal.org/2014/09/03/daughter-of-monroe-police-officer-in-need-of-life-altering-surgery/

      http://www.waltontribune.com/news/article_e2c77fc6-338c-11e4-ad6c-0019bb2963f4.html

      Again, our family thanks you for your help and support.

    9. Update

      John Fitzmayer
      Petition Organizer

      Nikki continues to make the news, which we hope will provide the opportunity to affect changes in the health insurance industry. In addition to http://triblive.com/news/allegheny/6675176-74/implants-cochlear-nikki#axzz3CDziCFLo and https://www.indiegogo.com/projects/help-nikki-hear--3/x/8460809 Nikki can also be found in the news at http://www.waltontribune.com/news/article_e2c77fc6-338c-11e4-ad6c-0019bb2963f4.html and at http://monroelocal.org/2014/09/03/daughter-of-monroe-police-officer-in-need-of-life-altering-surgery/
      We hope through this campaign to provide knowledge and an opportunity to not only grab the attention of CIGNA but also of legislative bodies who regulate the insurance industry. We thank you for your continued support. One more thing, Nikki Fitzmayer can now be GOOGLED!

      Daughter of Monroe police officer in need of life-altering surgery

      What do you do if your daughter needs life-altering surgery just to be able to lead a normal life? "Whatever it takes," says Lt. John Fitzmayer, an officer with the Monroe Police Department and father of a 4-year-old in need of cochlear ear implants.

    10. news

      John Fitzmayer
      Petition Organizer

      First allow my family and I to say thank you for the overwhelming and continued support through this difficult and long four years. Christopher Harris, who has donated so much of his time wrote a press release based on the successful achievement of last night's fund raising goals on
      https://www.indiegogo.com/projects/help-nikki-hear--3/x/8460809
      He has sent the press release to the Associated Press in Atlanta, Georgia. They can be contacted at 404-522-8971. We hope that everyone will encourage the Associated Press to tell Nikki's story so that other families will have an opportunity to learn how the health insurance industry truly works. For us, it has been a long and difficult journey where it seems we learned the rules of the game right after we lost the game. In Carl Prine's story at
      http://trib.me/1lrQgfD
      he was able to speak with a representative from CIGNA who offered great advice (it is what we received in the mail after they denied coverage for the third time). I thought it was interesting because through all of the petitions and appeals, I have never been able to speak with anyone at CIGNA regarding my daughter. I have always been re-routed to a third party who cannot give me any information except what they are directed to give. We hope that you will continue to support us and hopefully we can eventually make a change.

    11. A promise

      John Fitzmayer
      Petition Organizer

      Christopher Harris who is the publicist that put together the video and voice over for
      https://www.indiegogo.com/projects/help-nikki-hear--3/x/8460809
      has promised to write a story utilizing the eloquence and character that he is famous for if we reach $10,000 by 9:pm tonight. Apparently, because of all the support each of you has shown, we may be approaching a record of some type at indegogo.com. Again, I and my family thank you for everything.

    12. Recent Development

      John Fitzmayer
      Petition Organizer

      The insurance has of course denied our third appeal. A couple of weeks ago a person whom I have never met offered to help. Christopher Harris and his associate Cory Skyler have generously donated and spent countless hours putting together this crowd funding website. Through indegogo.com we are attempting to gather the funds needed to pay for Nikki's Cochlear Implant. Please visit
      https://www.indiegogo.com/projects/help-nikki-hear--3/x/8460809
      and also pass along to your friends and family via Facebook, Twitter, and through emails with friends and family. For further reading, Carl Prine, who is a reporter for the Pittsburgh Tribune wrote a story about Nikki in today's paper. Here is a link to that story; http://trib.me/1lrQgfD

      Gir's hearing at risk in tiff with insurer Cigna

      In the years after infant Nikki Fitzmayer received a lifesaving liver transplant in Children's Hospital of Pittsburgh, her parents began to realize that she was going deaf. Today they're fighting insurance giant Cigna to get cochlear implants so 4-year-old Nikki can hear again. And they are pushing lawmakers to review how government programs help the hearing impaired.

    13. Recent Update

      John Fitzmayer
      Petition Organizer

      We have not heard anything from the insurance company, so it seems we will have to continue the fight. As a side note, It seems that Mr. Dishaw has too much time on his hands, I would like to remind him and anyone else, you do not have to read this, but if you do please refrain from calling my daughter a retard, as she is hearing impaired, not mentally handicapped. Further updates to come soon.

    14. recent update

      John Fitzmayer
      Petition Organizer

      We are now awaiting a response from CIGNA on our third appeal to them. Nikki's doctors have sent additional information to CIGNA debunking all of their given reasons for denying the coverage. (they gave different reasons each time they have denied to cover the implant). We are just waiting for the 30 days to pass when they will give us their response. Of course in having to wait the full thirty days, another scheduled surgery has come and gone and another month of Nikki falling further and further behind in her development. My family and I greatly appreciate all the support that has been generated for Nikki. I hope one day to be able to tell her just how many people know her name and showed their support for her, and that she will be able to hear me.

    15. Reached 150,000 signatures

    Supporters

    Reasons for signing

    • Lisa Colley COVINGTON, GA
      • 13 days ago

      This is outrageous for an insurance company to play God by denying a surgery that would cause 180 degree improvement. Cigna should be ashamed.

      REPORT THIS COMMENT:
    • Nancy Lackaye GREENBELT, MD
      • 13 days ago

      i'm sure it's a waste of time to appeal to an insurance company's compassion, but think of the PR...?

      REPORT THIS COMMENT:
    • C C MIAMI, FL
      • 13 days ago

      human rights, kindness, dignity is more important then business, treat others as you would like to be treated, peaceful resolution, help the children

      REPORT THIS COMMENT:
    • CHERYL RIVERS MCDONOUGH, GA
      • 14 days ago

      because everyone is entitled to coverage no matter what it is for years the health industry collects money from every indivual monthly hoping you'll never need it just like the auto ins, companys , homeowners insurance you took money to supply insurance for health needs you the insurance companys need to approve the procedures

      REPORT THIS COMMENT:
    • robert thomson BROOKLYN, NY
      • 14 days ago

      every child should be able to hear even if the parents cant afford it help all childern even if they cant afford it

      REPORT THIS COMMENT:

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